Peritonitis on sigmoidal perforation in a cocaine user: A rare case report.

INTRODUCTION AND IMPORTANCE: Cocaine, the second most abused drug in Morocco after cannabis, has been associated with multiple cardiac, pulmonary, neurological, and digestive complications. Colonic perforation following cocaine abuse is relatively lesser-known and requires attention as abuse rates are increasing, and existing evidence is scarce. Only a few cases have been reported in medical literature. CASE PRESENTATION: We report the case of a 42-year-old male cocaine addict who presented with acute peritonitis. A laparotomy revealed a 3 cm perforation in the sigmoid, The absence of radiological, biological, and pathological evidence confirms the toxic origin of the perforation. CLINICAL DISCUSSION: Cocaine-induced ischemic colitis is a rare occurrence in a surgeon's clinical experience. This condition is typically confirmed through colonoscopy and often resolves without the need for surgery, although a small number of cases may advance to peritonitis, necessitating surgical intervention. CONCLUSION: Cocaine's adverse effects should be taken into account in the differential diagnosis of acute ischemic events in young adults. A general understanding of the significant complications associated with cocaine can aid in achieving early diagnosis and prompt treatment.

Primary signet-ring cell carcinoma of the cecum: A rare case report.

INTRODUCTION AND IMPORTANCE: Primary SRCC is a rare histological colorectal cancer subtype. It is characterized by distinct clinical presentation. CASE PRESENTATION: This case report describes a rare case of a Primary Signet-ring cell carcinoma of the cecum. A 37-year-old man came to the emergency department with bowel obstruction and altered general condition. The abdominal CT scan showed an intestinal occlusion upstream a thickening of the cecum. An exploratory laparotomy found a distention of the bowl with a suspect thickening of the cecum. The patient underwent a right ileo-colectomy and ileocolostomy. Histologic analysis of the operatory specimen confirmed the diagnosis of a primary Signet-ring cell carcinoma of the cecum. The recovery was uneventful, and the patient is in good health after six -months of follow-up. After completing the chemotherapy, the patient is scheduled for a colonoscopy and reversal of colostomy. CLINICAL DISCUSSION: Colorectal primary signet ring cell carcinoma (SRCC) is a rare entity, and it is associated with poor prognosis compared with common colorectal adenocarcinomas. characterized by distinct clinical presentation, with very poor response rates. CONCLUSION: Primary SRCC is an aggressive histological type of colon cancer and it is associated with a poor prognosis. There are no conclusive guidelines for the treatment of this type of tumor.